Impulsivity In Cocaine Abusers: Relationship to Drug Taking and Treatment Outcome

可卡因滥用者的冲动：与吸毒和治疗结果的关系

• 批准号: 8694439
• 负责人: Richard W Foltin
• 金额: $ 52.77万
• 依托单位: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8694439
• 关键词: Accounting; Age; Alcohol consumption; Behavioral; Behavioral inhibition; Binge Eating; Brain; Clinical; Cocaine; Cocaine Abuse; Cocaine Users; Cognitive; Cognitive Therapy; Control Groups; Data; Decision Making; Drug usage; Economics; Ethnic Origin; Exercise; Factor Analysis; Female; Foundations; Functional Magnetic Resonance Imaging; Future; Impulsive Behavior; Impulsivity; Laboratories; Measures; Modeling; Outcome; Participant; Patient Self-Report; Personality; Personality Traits; Pharmaceutical Preparations; Play; Process; Public Health; Punishment; Research; Research Design; Rewards; Risk-Taking; Role; Smoke; Structural Models; Structure; Testing; Treatment outcome; base; clinically relevant; cocaine use; discount; discounting; high risk sexual behavior; male; neurobehavioral; neuroimaging; novel; public health relevance; relating to nervous system; response; sex; social; success; therapy development; treatment strategy

DESCRIPTION (provided by applicant): Cocaine users 1) are more impulsive based on self-report measures, 2) have more difficulty inhibiting behavioral responses, 3) make poorer decisions in decision-making tasks, and 4) discount the value of future rewards at a faster rate than non-cocaine users, suggesting that impulsivity plays a role in cocaine abuse. After collecting data on these 4 domains in current cocaine abusers (n = 200) and matched controls (n = 180), we will conduct confirmatory factor analyses testing a second-order factor model of Impulsive Choice. We hypothesize that 3 first-order latent factors (personality/behavioral inhibition, risk taking, reward/punishment value) will account for the significant relations among the measures within each factor, and a single latent second-order factor (impulsive decision-making) will account for the relationships among the 3 first-order factors. We will test the abilit of our model to predict real world cocaine use and clinical outcome. Aim 1. Obtain self-report and task-based measures of 1) impulsivity~ 2) response inhibition~ 3) decision- making~ and 4) temporal discounting in cocaine abusers and matched controls in order to examine the correlational structure among the measures and test our model of Impulsive Choice. Aim 2a. Compare the structural model and the scores for each factor between groups. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both groups, but cocaine abusers will have greater scores on all factors. Aim 2b. Evaluate the predictive validity of our factors with respect to cocaine use. We hypothesize a positive relationship between our factors and current cocaine use. Aim 3. Compare the structural model and the scores for each factor between sexes. We hypothesize that the 4 latent factors of our model of Impulsive Choice will be observed in both sexes with the following rank order of factor scores: Female Cocaine Abusers > Male Cocaine Abusers > Male Controls > Female Controls. Aim 4a. Evaluate the predictive validity of our factors in 35 cocaine users with respect to neural measures of response inhibition and temporal discounting. Aim 4b. Evaluate whether the factors predict neural activity associated with decisions to smoke cocaine measured using a novel fMRI task (CNET) in 35 cocaine users. We hypothesize that our factors, with incorporation of neural measures of response inhibition and temporal discounting, will predict neural activity related to decisions to smoke cocaine and self-reported cocaine use. Aim 5. Evaluate the predictive validity of our factors with respect to treatment outcome for 100 participants for whom we will provide cognitive-behavioral treatment (CBT) for their cocaine use. We hypothesize that there will be a negative relationship between our factors and clinical outcome. Impact: A better understanding of the construct of impulsivity and which factors of impulsivity best predict clinica outcome will provide critical information to guide the development of therapies specifically targeting cognitive processes associated with those factors in drug taking.

描述(申请人提供)：可卡因吸毒者1)基于自我报告措施更冲动，2)更难抑制行为反应，3)在决策任务中做出更糟糕的决定，4)比非可卡因吸毒者更快地贴现未来奖励的价值，这表明冲动在可卡因滥用中发挥了作用。在收集了当前可卡因滥用者(n=200)和匹配对照组(n=180)这四个领域的数据后，我们将对冲动选择的二阶因素模型进行验证性因素分析。我们假设，3个一阶潜在因素(人格/行为抑制、冒险、奖惩价值)将解释每个因素内的测量之间的显著关系，而一个潜在的二阶因素(冲动决策)将解释三个一阶因素之间的关系。我们将测试我们的模型预测现实世界可卡因使用和临床结果的能力。目的1.在可卡因滥用者和配对对照组中获得1)冲动性、2)反应抑制、3)决策和4)时间折扣的自我报告和基于任务的测量，以检验这些测量之间的相关结构，并检验我们的冲动性选择模型。目标2a。比较不同组间的结构模型和每个因素的得分。我们假设我们的冲动选择模型中的4个潜在因素在两组中都会被观察到，但可卡因滥用者在所有因素上的得分都会更高。目标2b。评估我们的可卡因使用因素的预测有效性。我们假设我们的因素与目前的可卡因使用之间存在正向关系。目的3.性别间结构模型和各因素得分的比较。我们假设，我们的冲动选择模型的4个潜在因素将在两性中观察到，因素得分的排序如下：女性可卡因滥用者男性可卡因滥用者男性控制组女性控制组。目标4a。评估我们的因素在35名可卡因吸毒者中关于反应抑制和时间折扣的神经测量的预测有效性。目标4b。评估这些因素是否预测了与吸食可卡因的决定相关的神经活动，这些因素是使用一种新的功能磁共振任务(CNET)在35名可卡因使用者中测量的。我们假设，我们的因素，结合反应抑制和时间折扣的神经测量，将预测与吸食可卡因和自我报告的可卡因使用相关的神经活动。目的5.评估我们的因素对100名参与者的治疗结果的预测有效性，我们将为他们提供可卡因使用的认知行为治疗(CBT)。我们假设在我们的因素和临床结果之间会有负相关。影响：更好地理解冲动的结构以及哪些冲动因素最能预测临床结果，将为指导专门针对与吸毒中的这些因素相关的认知过程的治疗方法的开发提供关键信息。